The integrated palliative care outcome scale for patients with palliative care needs: Factors related to and experiences of the use in acute care settings

2019 ◽  
Vol 17 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Susanne Lind ◽  
Lars Wallin ◽  
Carl Johan Fürst ◽  
Ingela Beck
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Healthcare Professionals ◽  
Assessment Tools ◽  
Successful Implementation ◽  
Care Needs ◽  
Palliative Care Outcome Scale ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Care Outcome

AbstractObjectiveImplementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals’ experiences of the use of IPOS in acute care settings.MethodData were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals’ participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: “IPOS acting as a facilitator” and “barriers to the use of IPOS.” The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals’ feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals’ participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.

scholarly journals What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie M. C. Ament ◽  
Lisette M. van den Broek ◽  
Marieke H. J. van den Beuken-van Everdingen ◽  
Josiane J. J. Boyne ◽  
José M. C. Maessen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Qualitative Study ◽  
Needs Assessment ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Care Needs ◽  
Palliative Care Needs

Abstract Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

scholarly journals Characteristics for a tool for timely identification of palliative needs in heart failure: The views of Dutch patients, their families and healthcare professionals

2020 ◽  
pp. 147451512091896 ◽  
Author(s):  
Daisy JA Janssen ◽  
Stephanie MC Ament ◽  
Josiane Boyne ◽  
Jos MGA Schols ◽  
Hans-Peter Brunner-La Rocca ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Healthcare Professionals ◽  
Family Members ◽  
Relative Advantage ◽  
Successful Implementation ◽  
Care Needs ◽  
Design Quality ◽  
Palliative Care Needs

Background Palliative care can improve outcomes for patients with advanced chronic heart failure and their families, but timely recognition of palliative care needs remains challenging. Aim The aim of this study was to identify characteristics of a tool to assess palliative care needs in chronic heart failure that are needed for successful implementation, according to patients, their family and healthcare professionals in The Netherlands. Methods Explorative qualitative study, part of the project ‘Identification of patients with HeARt failure with PC needs’ (I-HARP), focus groups and individual interviews were held with healthcare professionals, patients with chronic heart failure, and family members. Data were analysed using the Consolidated Framework for Implementation Research. Results A total of 13 patients, 10 family members and 26 healthcare professionals participated. Direct-content analysis revealed desired tool characteristics for successful implementation in four constructs: relative advantage, adaptability, complexity, and design quality and packaging. Healthcare professionals indicated that a tool should increase awareness, understanding and knowledge concerning palliative care needs. A tool needs to: be adaptable to different disease stages, facilitate early identification of palliative care needs and ease open conversations about palliative care. The complexity of chronic heart failure should be considered in a personalized approach. Conclusions The current study revealed the characteristics of a tool for timely identification of palliative care needs in chronic heart failure needed for successful implementation. The next steps will be to define the content of the tool, followed by development of a preliminary version and iterative testing of this version by the different stakeholders.

Implementation of the integrated palliative care outcome scale in acute care settings – a feasibility study

2018 ◽  
Vol 16 (6) ◽  
pp. 698-705 ◽  
Author(s):  
Susanne Lind ◽  
J. Sandberg ◽  
T. Brytting ◽  
C.J. Fürst ◽  
L. Wallin
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Patient Reported Outcome Measures ◽  
Palliative Care Unit ◽  
Positive Effects ◽  
Palliative Care Outcome Scale ◽  
Patient Reported ◽  
Acute Care Settings ◽  
The Impact ◽  
Care Outcome

AbstractObjectiveAlthough hospitals have been described as inadequate place for end-of-life care, many deaths still occur in hospital settings. Although patient-reported outcome measures have shown positive effects for patients in need of palliative care, little is known about how to implement them. We aimed to explore the feasibility of a pilot version of an implementation strategy for the Integrated Palliative care Outcome Scale (IPOS) in acute care settings.MethodA strategy, including information, training, and facilitation to support the use of IPOS, was developed and carried out at three acute care units. For an even broader understanding of the strategy, it was also tested at a palliative care unit. A process evaluation was conducted including collecting quantitative data and performing interviews with healthcare professionals.ResultFactors related to the design and performance of the strategy and the context contributed to the results. The prevalence of completed IPOS in the patient's records varied from 6% to 44% in the acute care settings. At the palliative care unit, the prevalence in the inpatient unit was 53% and the specialized home care team 35%. The qualitative results showed opposing perspectives concerning the training provided: Related to everyday work at the acute care units and Nothing in it for us at the palliative care unit. In the acute care settings, A need for an improved culture regarding palliative care was identified. A context characterized by A constantly increasing workload, a feeling of Constantly on-going changes, and a feeling of Change fatigue were found at all units. Furthermore, the internal facilitators and the nurse managers’ involvement in the implementation differed between the units.Significance of the resultsThe feasibility of the strategy in our study is considered to be questionable and the components need to be further explored to enhance the impact of the strategy and thereby improve the use of IPOS.

Meeting Palliative Care Needs in Post–Acute Care Settings

JAMA ◽  
2006 ◽  
Vol 295 (6) ◽  
pp. 681 ◽  
Author(s):  
Laura C. Hanson ◽  
Mary Ersek
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Care Needs ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Post Acute Care

scholarly journals What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne M. Finucane ◽  
Connie Swenson ◽  
John I. MacArtney ◽  
Rachel Perry ◽  
Hazel Lamberton ◽  
...  
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Professionals ◽  
Psychological Needs ◽  
Care Providers ◽  
Specialist Palliative Care ◽  
Care Needs ◽  
Complex Needs ◽  
Sequential Explanatory ◽  
Palliative Care Needs

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.

scholarly journals Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review

2020 ◽  
pp. 026921632096394 ◽  
Author(s):  
Stephanie MC Ament ◽  
Inge ME Couwenberg ◽  
Josiane JJ Boyne ◽  
Jos Kleijnen ◽  
Henri EJH Stoffers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Care Process ◽  
Care Needs ◽  
Process Guidance ◽  
Palliative Care Needs

Background: The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. Aim: To identify tools to help healthcare professionals recognize palliative care needs in patients with advanced chronic heart failure. Design: This systematic review was registered in the PROSPERO database (CRD42019131896). Evidence of tools’ development, evaluation, feasibility, and implementation was sought and described. Data sources: Electronic searches to identify references of tools published until June 2019 were conducted in MEDLINE, CINAHL, and EMBASE. Hand-searching of references and citations was undertaken. Based on the identified tools, a second electronic search until September 2019 was performed to check whether all evidence about these tools in the context of chronic heart failure was included. Results: Nineteen studies described a total of seven tools. The tools varied in purpose, intended user and properties. The tools have been validated to a limited extent in the context of chronic heart failure and palliative care. Different health care professionals applied the tools in various settings at different moments of the care process. Guidance and instruction about how to apply the tool revealed to be relevant but may be not enough for uptake. Spiritual care needs were perceived as difficult to assess. Conclusion: Seven tools were identified which showed different and limited levels of validity in the context of palliative care and chronic heart failure.

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